慢性阻塞性肺病合并肺结核56例临床分析

目的探讨慢性阻塞性肺病（ chronic obstructive pulmonary disease, COPD ）合并肺结核的临床诊治特点。方法对我科2009年1月至2012年10月收治的COPD合并肺结核患者56例的临床资料进行回顾性分析。结果COPD合并肺结核患者多见于老年男性（76．8％1，且吸烟者较多。临床症状、影像学表现及辅助检查无特异性。痰抗酸杆菌检出率低（23．2％），PPD试验阳性率低（30．4％），结核中毒症状不明显。规范治疗后大部分患者获得好转。结论临床上COPD合并肺结核并不少见，且易造成漏诊、误诊，需引起重视。及早诊断、规范治疗是该病获得良好治疗的关键。

Chronic obstructive pulmonary disease complicated by pulmonary tuberculosis in 56 patients

Objective To explore the clinical characteristics of the diagnosis and treatment of chronic obstructive pulmonary disease （COPD） concurrent with pulmonary tuberculosis. Methods The clinical data on 56 patients with COPD complicated by pulmonary tuberculois who had been treated during the period of January 2009 to October 2012 were retrospectively analyzed. Results COPD concurrent with pulmonary tuberculosis mainly occurred in elderly males （76.8%）, most of whom were smokers. No distinctive symptoms, chest X-ray patterns, and laboratory test results were found. The detection rate of acid-fast bacilli in sputum was low （23.2%）; and PPD test was positive in only 30.4% of all the patients. No marked tuberculosis-ralated toxic symptoms were seen. After regular treatment,medical conditions were improved in a majority of the patients. Conclusions COPD complicated by pulmonary tuberculosis is not uncommon. Missed diagnosis and misdiagnosis are easy to occur in this condition, to which we should pay attention. Early diagnosis and regular treatment are key to achieving a better efficacy.